Medication legal question

Nurses Medications

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I have searched the internet high and low and cannot find an answer. I thought I would check in to see if anyone can answer this. I am a RN in a medical setting. I gave an Invega injection to a psych patient and then waited for the pharmacy to send me the dose that is given a week later. The doctor decided he wanted me to give the injection a couple of days early and i explained to him that the injection had not been sent over from the pharmacy. He told me just to give a sample and I asked what I would do with the patients delivered prescription. He said to just tear the label off and use it on another patient in the future. This does not sound legal to me and I have not been able to find an answer to this without actually calling the board of pharmacy. I refused to follow his advice.

babyreed07

20 Posts

Hi. I currently work at an LTC pharmacy & have for 6 years now. I can tell you from my experience what the MD said is completely incorrect! When the med is delivered from the pharmacy just refuse/return for credit. I don't know your patient's financial situation, but I'm sure his/her insurance paid for the med & it wouldn't be right or legal for that matter to use it on another patient. I know our Nursing facilities borrow from Peter to pay Paul all the time when it comes to meds.. When that occurs it usually messes up refill dates for one or more patients. Hope this was helpful.

Specializes in critical care, ER,ICU, CVSURG, CCU.

in texas, and my nurse practice act, i would be in violation , re: taking off label and using for another patient would be practicing pharmacy,

MunoRN, RN

8,058 Posts

Specializes in Critical Care.

It depends on whether or not your clinic is allowed to stock this particular medication. It is legal for nurses to administer medications, which include giving medications kept in-stock that aren't pre-designated for that particular patient, by interpreting the order itself include the medication, route, dose, etc. If the medication still retained all the required information with the pharmacy label removed (name of medication, dosage, exp date, etc), then it would be no different than any other stocked med.

How the billing would be sorted is probably more complicated, particularly if the patient is billed by the pharmacy when they fill the order, rather than the clinic purchasing the medication and then billing the patient.

What nurses can't do is dispense, which is the interpreting of an order and preparing it for use by a patient or someone who is not allowed to "administer". This would include labelling, or relabelling, a medication for use by the patient.

babyreed07

20 Posts

I agree with that to an extent. Stock meds are usually OTC's not RX meds. E-Box's are different. Why should the patient's insurance pay for a med (which Invega is not cheap btw) that another patient will use. Technically that's fraud.

Specializes in psych.

I had a similar situation with Abilify Maintena. My patient arrived to the clinic, but their prescription had not been filled by the pharmacy. This was the same problem last month. The patient did not receive the medication last month. I called the pharmacy, who was still unable to fill the prescription and I also notified the provider. The psychiatrist at the clinic told me to use another client's Abilify, as it had been d/c for that client. I was uncomfortable with this, but it was the correct medication and dose and it was unexpired. The psychiatrist verified that the client for whom the medication had been d/c-ed would never again be put back on Abilify Maintena. What should I have done?

morte, LPN, LVN

7,015 Posts

I agree with that to an extent. Stock meds are usually OTC's not RX meds. E-Box's are different. Why should the patient's insurance pay for a med (which Invega is not cheap btw) that another patient will use. Technically that's fraud.

the patient got what their insurance paid for.

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